Direct Peroral Cholangioscopy

The goal of this most recent stone management tool, direct peroral cholangioscopy, is to avoid mother and baby scope system limitations. Direct peroral cholangioscopy uses an ultraslim upper endoscope with a 4.9- to 6-mm tip diameter and greater than 140 cm length and is conducted by a single endoscopist. The procedure generally requires a large sphincterotomy, a terminal CBD greater than 10 mm diameter, placement of a guide wire or anchoring balloon into a peripheral bile duct via standard ERCP, passage of the direct cholangioscope over the anchoring balloon/wire, removal

Fig. 5. Spyglass Spyscope system (A) and the cholangioscopic image (B).

of the anchoring wire, and then use of intraductal lithotripsy. A nasobiliary drain for flushing out fragments may be needed. An overtube may be needed to prevent intragastric bowing. Experience is limited, but recent studies show feasibility and clinical usefulness.42,43 Limitations of the technique included limited availability of such prototype endoscopes, limited experience to date, and tendency for the endoscope to fall back into the duodenum.

Get Rid of Gallstones Naturally

Get Rid of Gallstones Naturally

One of the main home remedies that you need to follow to prevent gallstones is a healthy lifestyle. You need to maintain a healthy body weight to prevent gallstones. The following are the best home remedies that will help you to treat and prevent gallstones.

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